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<br /> Ji 4 it �I�I �i�1 711�1( d��ll rIY � ,i�� 5 � i .��IA ; Y �� � J'�M� j ��; �r,i '^'�`.jJ'.��.�,��:����'�I{ i! :y,•ry �1,� '�I
<br /> 11 i3 ii �I 14� 1�'q�r� � f If �, �It I i � �� �n � �I I�� � i � � ��� � i(�' d' .�£ �{i �h u�t �h! t i' �i I
<br /> v '� L I l ��.1 la ! I�,��E��i, f F7 i�j� �!rr � I �I� , ( ti �
<br /> �,�fl�i'1!�, 'SI'J;� �I;�IlSi�r.�h��1,1`- �f;llli���.F. �.I�.. �� �� !r�ll1� i7 �. �� ` ,l`',' 41°.n4 n I IG 'V�f � �iF�
<br /> ���� �i '�i���-�F:�l 'il �1. .I�';rnJ:!.� 17 ,I.,, � �,,1 ����,�4�
<br /> ❑ ��s,tfus accrion applics
<br /> The replt�cment of a Rtsiden 'a1�xture or appliatict lhat mccts all t�utc of the followir�rcquirem,�nts:
<br /> 1. bocs not xequirc modification to eltctrical or gas service. -
<br /> 2. �Tbs s total cos'l•of$500.40 or lees;cxcl in the cost of the fizL•ure oe appliance:and
<br /> 3. Is improved, insta.11ed or replaccd by the homeowner or licensod contraetor.
<br /> Skip next saction,if this applics; Cost of PGrn�it $ 15.110
<br /> State 5urcharge $ ,50
<br /> Mail-In Fee(If Applicable) S 1.50
<br /> Total Prrmit Fee �
<br /> , ;, . ,
<br /> ,,�,,,,.
<br /> . qp .p'� yI
<br /> ���I'�i�,r.:�;`(.�.��;ihl�l���+1'�1''K�f ti �... �nf I��
<br /> �,���I,' ' tn i T i�
<br /> Tf�ibovc does not apply;foiJow guidelines below:
<br /> 1. CONTRACT PRICE *is 1_25%of contract price with a(Mlnimum Fee ot'$35.Op)
<br /> x.
<br /> �0� x.012S$ 5 � �
<br /> (contru�t pnce) (minimum 535,00)
<br /> 2. STA'I'F,SURCHAI2GE **Add tho Stat�Bldg Codt Div.Sutch�ge(Minimum Fec u�S.SO)
<br /> �� �.o�as �_�?. J 0
<br /> (contract pricc) (minimum S .SO)
<br /> 3, POST,AGE&HANp�;YNG(Only on Mail-Tn Applicatious) � 1.50
<br /> 4. TOTAL p�RMIT�EE(Add Lincs 1-3 Abova) $� �Q
<br /> • '� CQN'!'�tACT PRICE or JOB COST means tht actual or estimated dollar amount charged for the
<br /> permittcd work including materials, labor,profi��, and other fixed costa. It is the amoum to'br charged
<br /> to thc customer for thc work don�_ LF any matrsial, equipment, labor or ins�llations are fiunished by
<br /> tho owner, tenant or any ot�ier parry, the reasonable market value of such itcros m,ust be added to th�
<br /> ashinated cosc �r contract pricc for pernut fce pur�,nsds. In the cvent tl�at there�is a dispute on thc
<br /> amount of thc job cost, thc City may rcquest tlie submission of s si�ned copy of the actual contract.
<br /> ■ '"'"Thc STATE S'C_TRCH,ARGL�is .00OS of tht Building bcpartment at(952)249-4640 for tht price.
<br /> �11114(�i I �'Vrl r�IL.�II'(��i�i��l.�k�l���"t,� �1 � �, •r � } .i��i�T`�l:�%���D �i�a�3�ic.?
<br /> Th� undersigned he�by applies to the City i'or issuance of a Mech•anical Permit, agrees Yo do all
<br /> work in strict aceordancc with th� ordinanees of the Ciry and the re�ulations of the State of
<br /> Minnesota, and certifies �hat all sl'alements made on this application are complete, tru� and
<br /> conect.
<br /> Applicant's Sigz�ature; - Date: / � /
<br /> 3
<br /> 99/�0 �Jtid �lOQNO� LBZLLZLE9L 6T ��Z ITOZ/TT/0T
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